Pre-Authorization Spec Team A- Must have direct insurance portal experience

About Our Client:The organization operates in the healthcare industry, providing patient care across multiple hospitals and medical centers in central and southeastern Illinois. It addresses challenges in healthcare delivery by supporting a large network of providers and advancing medical education through associated colleges. The organization emphasizes nursing excellence and offers growth opportunities within several communities. About the Opportunity:The PRE-AUTHORIZATION SPEC TEAM A is responsible for managing prior authorization processes to ensure insurance coverage for scheduled and additional medical services. This role impacts the organization by facilitating timely service approvals, reducing claim denials, and supporting effective communication between providers and payers to improve patient care workflows. Responsibilities:Identify prior authorization requirements based on insurance/payer.Process and complete prior authorizations for scheduled and add-on services.Determine if services are covered benefits and document information in Epic.Communicate authorization outcomes to ordering providers to reduce denials.Facilitate peer-to-peer reviews when necessary.Utilize insurance portals proficiently for pre-authorization submissions.Advocate for patients and providers by securing clinical information and timely processing.Identify challenges and trends to work with management on resolutions.Perform other duties as assigned. Requirements:High school diploma or GED.Basic reading, writing, and oral English communication skills.Ability to maintain confidentiality and communicate facts professionally.Basic computer skills including word processing, spreadsheets, email, and web browsing.Comfortable using Windows OS and learning new applications. Pay Range and Compensation Package:The compensation range for this position is $18 per hour to $29.13 per hour.Actual compensation depends on experience, qualifications, location, training, licenses, shifts worked, and compensation model.A comprehensive benefits package is offered. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.